Dermatological systems and methods with handpiece for coaxial pulse delivery and temperature sensing

A system for treating the skin of a patient with therapeutic laser light pulses, the system comprising:

• a) a laser source capable of generating therapeutic laser light pulses;
• b) a handpiece optically coupled to the laser source to receive the therapeutic laser light pulses, and capable of directing the therapeutic laser light pulses to one or more target skin areas along a first optical path, the handpiece comprising:
• 1) a first optical element comprising one of a refractive element and a reflective element, and having a first open area comprising one of an aperture and a slot, wherein the first open area is located in the first optical path;
• 2) at least one second optical element comprising a movable mirror located in the first optical path and movable in at least two axes for directing one or more therapeutic laser light pulses to a selected one of the one or more target skin areas;
• 3) a contact cooling unit comprising a cooling window adapted to contact and cool a first skin area of the patient, wherein the cooling window is located in the first optical path and comprises a thermally conductive material that is transmissive to infrared energy and the therapeutic laser light pulses, and each of the one or more target skin areas comprises a fraction of the first skin area;
• and
• 4) a temperature sensing element for sensing infrared energy radiated from the selected one of the one or more target skin areas through the cooling window along a second optical path that is generally counterdirectional to, and shares a common optical axis with, the first optical path for at least a portion of the first and second optical paths, wherein:
• the first optical element and the at least one second optical element are located in the second optical path;
• the movable mirror is positioned within the handpiece to direct one or more laser pulses to the selected one of the one or more target skin areas, receive infrared energy radiated from substantially only the selected one of the one or more target skin areas, and direct at least a portion of the received infrared energy to the first optical element;
• the first optical element is positioned to receive the at least a portion of the infrared energy from the movable mirror and to direct the received infrared energy to the temperature sensing element;
• and
• the temperature sensing element is capable of generating a first signal indicative of the infrared energy;
• and
• c) a temperature determination unit for determining a surface temperature of the selected one of the one or more target skin areas based on the infrared energy radiated from the selected one of the one or more target skin areas through the cooling window along the second optical path, the temperature determination unit comprising:
• a controller comprising at least one processor adapted to process the first signal to determine the surface temperature of the selected one of the one or more target skin areas at one or more timepoints before, during, or after the application of the therapeutic laser light pulses to the selected one of the one or more target skin areas.

A system for treating the skin of a patient with therapeutic laser light pulses, the system comprising:

• a) a laser source capable of generating a plurality of therapeutic laser light pulses;
• b) a handpiece optically coupled to the laser source to receive the plurality of therapeutic laser light pulses, and capable of directing one or more of the plurality of therapeutic laser light pulses to a selected one of a plurality of target skin areas along one of a plurality of first optical paths, wherein at least a portion of each first optical path of the plurality of first optical paths is different from every other first optical path for each target skin area in the plurality of target skin areas, the handpiece comprising:
• 1) a first optical element comprising one of a refractive element and a reflective element, and having a first open area comprising one of an aperture and a slot, wherein the first open area is located in each of the plurality of first optical paths;
• 2) at least a second optical element comprising a movable mirror located in each first optical path of the plurality of first optical paths, wherein the mirror is movable by an electric motor to a plurality of different positions for directing each of the plurality of therapeutic laser pulses sequentially to a selected one of the plurality of target skin areas;
• 3) a contact cooling unit comprising a cooling window adapted to contact and cool a first skin area of the patient, wherein the cooling window comprises a thermally conductive material that is located in each first optical path of the plurality of first optical paths and is transmissive to infrared energy emitted from the first skin area and the therapeutic laser light, and each target skin area of the plurality of target skin areas comprises a different fraction of the first skin area cooled by the contact cooling unit;
• and
• 4) a temperature sensing element for sensing, when the movable mirror is positioned at each position of the plurality of different positions, infrared energy radiated from substantially only a selected one of the plurality of target skin areas through the cooling window along a selected one of a plurality of second optical paths, wherein each second optical path of the plurality of second optical paths is generally counterdirectional to, and shares a common optical axis with, one of the plurality of first optical paths for at least a portion of the first and second optical paths, wherein:
• the first optical element and the movable mirror are located in each of the plurality of second optical paths;
• the movable mirror is positioned within the handpiece to, at each one of the plurality of different positions, direct one or more laser pulses to the selected one of the plurality of target skin areas, receive infrared energy radiated through the cooling window from substantially only the selected one of the plurality of target skin areas, and to direct at least a portion of the infrared energy from the selected one of the plurality of target skin areas to the first optical element;
• the first optical element is positioned to receive the at least a portion of the infrared energy from the movable mirror and to direct the infrared energy received from the movable mirror to the temperature sensing element;
• and
• the temperature sensing element is capable of generating a first signal indicative of the infrared energy received from the first optical element;
• and
• c) a temperature determination unit for determining a surface temperature of the selected one of the plurality of target skin areas based on the infrared energy received from the first optical element, the temperature determination unit comprising
• a controller comprising at least one processor adapted to process the first signal to determine the surface temperature of the selected one of the plurality of the target skin areas at one or more timepoints before, during, or after the application of the therapeutic laser light to the selected one of the plurality of target skin areas.